"But in practice, the policy distance between “strict rules that we don’t enforce” and “weak rules but most people try to be cautious” is not nearly as great as the political fighting would imply. And a lot of the dialogue on “do Covid mitigation measures work?” has, I think, failed to properly distinguish between the measures and the policies."
^^
This particularly hits home in Japan, where the progressive expat community that is loud on Twitter about how feckless the weak rules are in Japan consistently falls quiet when "State of Emergency" rules that basically just ask restaurants to close at 8pm and stop serving alcohol actually do reduce cases of Covid in Tokyo.
"What is true, though, is that the impact of Covid restrictions has been modest."
We learned what restrictions made sense as we went along. At first there was an assumption that SARS-CoV-2 spread by surfaces/touch, so we had all these restrictions about cleaning surfaces and washing hands. It made sense at the time, but it all turned out to be useless.
Then we believed it was all about droplets (which fall to the ground within six feet) so we distanced by six feet and wore any old mask. The distancing turned out to be useless and most of the masks, and/or the way they were fitted, turned out to be of marginal use.
Then we finally learned that it was really all about aerosols and that the most important thing by far was indoor ventilation. We learned that masks had to be high filtering and tight fitting all around the edges. Most people continued to wear masks that could uselessly stop droplets but barely make a dent in aerosols (often due to big gaps on both sides of the nose).
It was a learning process, and by the time we learned what we needed to know it was too late, and many people were too confused by the ever-changing story to get it right anyway.
Covid restrictions can't work if they are the wrong ones, but we couldn't have known what the right ones were without first having gone through the whole process.
I read the Mandavilli article before reading your rebuttal. I did think Mandavilli's opening gambit of declaring "missteps" smacked of tough-journalism theater, but I did not find the profile negative as a whole.
Mandavilli quotes people we respect as praising Walensky, calling her the best person for the job, and predicting a good press for her by the end of a year (Fauci). Those positive remarks also imply, as Mandavilli recaps at the end of the article, that "the flawed communications in recent weeks suggest that she is still finding her way." I think your point is that the communications were not flawed, but that's less than a major objection to a largely positive profile.
I don't know about Mandavilli's track record, but this piece did not strike me as anything like doomerism. By the way, responsibility for the raised-eyebrow headline and subhead almost certainly lies with an editor, not the author.
Isn’t part of the hopeful outcome of the CDC guidelines to promote vaccination by admitting you don’t need a mask after full vaccination? There was a big surge of vaccine appointments after the announcement. Also since the CDC changed their guidelines, Covid cases continued to fall. Was there any evidence anywhere of an uptick in infections?
The other day a man drove past me on a dirt bike, popping a wheelie down a residential street at dusk, helmetless - but wearing a surgical mask, which he carefully adjusted with one hand after landing his front wheel on the road.
It was funny, but reminded me yet again that normal people just plain suck at any sort of risk assessment. If you are reading through multiple articles to try to figure out how to model the relative risk of various behaviors so you can understand the tradeoffs, then you are a weirdo. As am I.
It's frustrating watching the public health establishment implicitly accept that people suck at this to some degree, but then conclude that that's why they need to manipulate everyone - because they just won't "get it" otherwise. The opposite conclusion is more reasonable: people suck at this, so we should try to make all of our communications simple, clear, fact based, and as far as possible, intuitive. ("People breath the virus out, so if you're gonna spend time inside, open a couple windows" is not something you need a complicated risk assessment to understand) The CDC's communication is far from perfect now, but it's vastly improved since the Trump administration ended.
I was on a shuttle heading to a wedding last weekend for a very progressive and liberal friend of mine who has a very liberal and progressive social circle. I noticed everyone had masks on (and were vaccinated) but I was the only one wearing my seatbelt as we drove down the freeway. Later that night they passed around and drank from a bottle of whiskey and somebody said "hey we're all vaccinated". I thought "yeah, from covid, but not from lots of other diseases". Still drank the whiskey of course of I'm not a complete buzzkill
One issue with that is you can't say "open some windows" without data confirming that will actually work. And since we can't throw random people in a room with someone sick and see what happens and then try it again with a new group and an open window, you're kind of stuck.
Not a dig at you personally, but this kind of thinking drives me crazy. Are we really institutionally unable to reason under uncertainty?
If I kidnapped 100 epidemiologists and lock them in individual rooms with COVID positive patients and a single window, would any of them not open the window and stand next to it?
Life doesn't wait for perfect info for perfect communications. We have to do the best we can with what we have. In April of 2020, that would have meant telling people to open a window if they insisted on being inside with others outside their households.
And if you're honest about the limitations of your data, and why you're making the best recommendation that you can, people are more likely to listen when you update based on new data. If they sense that you're BS'ing them from the start, they're going to suspect that you're still BS'ing them when you change the guidance.
In the kidnapping scenario, the epidemiologists have no cost to opening the window - if it's efficacy isn't negative, they might as well. It might be hygiene theater but there's no cost to them for doing it.
On one hand, reasoning under uncertainty is necessary. But if we have _no_ real data, I think guessing is counter-productive. So I don't need double-blind trials for the open window theory but some evidence other than "epidemiologists would do it if they had no other options" is needed to reason under uncertainty.
It seems like common sense that opening windows increases ventilation and airflow. By how much exactly I don't know. But there are plenty of studies on air circulation so data for making inferences is out there.
My common sense says that if I have 10 people in my dinning room and I open the window on a calm day, the little bit of breeze would somewhat decrease the concentration of viral particles. But not by much.
Picture you're at a dinner party with 10 people in your dining room and a few of them are smoking. Would opening the windows make a little bit of difference in lowering the smoke in the air or a lot?
I was thinking about a Smokey kitchen as an example. It helps a little. But if they or the stove are still smoking it’s still going to be pretty Smokey. Now if you’re saying put a box fan in one of the windows? That would make a huge difference. Especially with some cross ventilation. But that’s a lot more than just open a window.
I have noticed that a lot of people I know are very upset about the CDC rolling back mask requirements and the reason is usually that it freaks them out because it seems unsafe to them. And they’re the type who’ve spent the last year saying the believe in a science. They also spent early 2021 consuming news from sources that insisted we had no idea if the vaccines prevented infections so they also had to get used to the idea that being vaccinated means you almost certainly can’t infect others.
Some of that could have been mitigated if the CDC had done a better job of communicating risk throughout the pandemic.
Or if the CDC had *ever* done a better job of communicating risk. They seem to speak a language entirely of "do"s and "don't"s, with no "A is riskier than B is riskier than C, and you can use this information together with your priorities to determine which things you should and shouldn't do".
Also, I always want to rant about how carcinogens are classified - by strength of *evidence* that an association exists with cancer, and *not* by degree of risk increase:
"The lists describe the level of evidence that something can cause cancer, not how likely it is that something will cause cancer in any person (or how much it might raise your risk). For example, IARC considers there to be strong evidence that both tobacco smoking and eating processed meat can cause cancer, so both are listed as “carcinogenic to humans.” But smoking is much more likely to cause cancer than eating processed meat, even though both are in the same category."
I want to very strongly push back on the idea that health authorities were lying about masks. IIRC the best studies they had at the time were out of Vietnam during SARS and the question was, "Does wearing a mask in the home with someone who is sick with SARS prevent infection?" And they answer is not really. But that's an entirely different question than does wearing a mask in line at the supermarket or while getting your hair cut prevent transmission. The answer to that is most certainly yes.
Did Abbott "jump the gun" by removing mandates on March 2? Matt is pretty fair in judging the motivations behind his actions, but shouldn't we inquire what happened next? When the March 2 order came out, Texas cases had dropped 65% from its mid-January high. And after the mandates were removed? Well . . . cases dropped another *85%* (https://www.worldometers.info/coronavirus/usa/texas/) Maybe he just got lucky, but I'd rather my governor be lucky than smart.
The other thing that irks me is the debate about masks early on: >>What the experts didn’t know is that apparently, it’s pretty easy to make a cloth mask. <<
Not sure what this means but it doesn't make any sense. Does it mean, folks, it's easy to make a mask at home? Well, maybe, and people would have done that, but only after emptying all the stores of masks, insuring healthcare personnel couldn't get them. Humans, you know. Or did it mean that factories could easily make cloth masks? Maybe, but that sure wouldn't have happened immediately. I have a good friend who managed the supply chain for a group of California hospitals and the stories he tells of trying to get supplies -- including masks -- early in the pandemic are chilling. People rushing out to CVS would only have made that much worse.
So, sure, the CDC shouldn't lie (credibility and all that), but how would telling people that masks were good have possibly helped protect vitally needed supplies for healthcare workers? It was a rock and a hard place and there was no obvious right answer. I can't blame them too much.
Couple of niggling things bother me. Your faith in Hepa filters for one. HVAC systems are an excellent way of distributing disease as Legionnaire's Disease demonstrates so well. And I assure you that if you are placed between the air return or inlet of any filter system and a person shedding virus into the air it does not matter how efficient the filter system is. You are in the line of fire. But there are, as you remark, other kinds of expertise.
Now let me channel Donald Rumsfeld. There is a lot you could and should criticize about that man but his known knowns speech is not one of them. And we have a bit of a problem here of the known unknown variety. That would be the fact that evolution never sleeps. The rise of new variants was easily predictable by virologists and anybody else who knew the elements of this theory but not much covered in the press until they began to appear. Frankly that scared me more than anything else and still does. Evolution is still not sleeping and there is no reason whatsoever that new variants that are more transmissible, more lethal and which affect different demographic groups like children cannot arise. Every single case of infection represents an opportunity for evolution. Any long term strategy to contain Covid must take this into account. Nowhere in this piece is that very serious problem considered.
Everyone knows that. The interesting question is what the United States will do during those couple months when the new variant is spreading among vaccinated people, while everyone is lining up to get their new vaccine. Will we go back to full-time isolation and work from home and masking?
It is impossible for us to go any faster in creating the vaccine. Why? Because it took us *two days* for moderna to make the vaccine. The rest is bureaucracy.
I'm so sick of the people who think it's the government's job to play jedi mind tricks to manipulate the population into doing things. It's the government's job to provide information and reasonable guidance informed by that information.
So instead of saying, "Masks only work for doctors; regular schmucks like you can't possible use them correctly," they should have said, "Masks are useful, but doctors and first responders need them more than you do, so please don't horde them." Instead of saying "COVID is a serious risk for your average 20-year-old, so get vaccinated to save yourself", say "The risk of COVID to your average 20-year-old isn't very big, but please take one for the team and get vaccinated to help people at higher risk than you."
The people who advocate for these jedi mind tricks tend to also be the people who wonder why the people who don't fall for these jedi mind tricks have such low faith in government. Just treat people like adults. If you want to change people's mind, hire Frank Luntz to manipulate people like adults https://debeaumont.org/news/2021/focus-group-vaccines-republicans/ (Not a sentence I expected to type.)
This is exactly right. This idea that you can turn around people who are skeptical of government officials by shading the truth is nuts. You just provide ammunition for the people who want to undermine the message. Sticking to the facts is a much better strategy.
My observation has been that academic schools of public health are extremely paternalistic, and tend to attract students who are both earnest and highly controlling.
Yes, this is a good point. I am a graduate student in public health and the default position here for any given issue is that the government should dictate what people can do.
It’s worth noting that “The people who advocate for these jedi mind tricks tend to also be the people who wonder why the people who don't fall for these jedi mind tricks have such low faith in government” is natural when you think about it - they’re just projecting their own credulity downward.
"But Texas’ motor vehicle fatality rate is 37% higher than California’s and Florida’s is 63% higher. I have no idea what accounts for those gaps. But whatever it is, we manage to not be having entrenched culture war fights about it."
Traffic fatalities are a function of miles driven and impact intensity. Impact intensity is called "Delta-V" or the change in velocity during impact. The industry benchmark is fatalities per 100 millions miles driven.
California is at 1.06.
Texas is at 1.21 (14% higher than California).
Florida is at 1.41 (33% higher than California).
So part of your per-capita difference is higher miles driven and the other part is traffic. So speeds in Texas and Florida are higher than California which increases accident intensity.
Emily posted this link from 2019. I have 2020 but I don't know if it's published yet.
"Traffic fatalities are a function of miles driven and impact intensity. "
Also distance to emergency medical care. Deaths per 100 million in MA is 0.51. In Montana it's 1.43. It's not because MA has better drivers, it's because they have quicker access to better hospitals.
In our household we noted that the CDC Director's kids are old enough to be vaccinated, where-as in our household, our 4-year old and 2-year old are not. It's not the case that if you want the vaccine you can get it--you also have to be over 12 years old. And, while for now, we don't anticipate major risks to little kids, that could certainly change with the new variants. I've generally felt like parents of small kids have gotten a short end of the stick this last year and the CDC's approach didn't acknowledge our position any better.
If the existent variants of the virus aren't a serious risk to small kids, then why should the government take preemptive action to mitigate risks from hypothetical, nonexistent variants of the virus? Why don't we cross that bridge if we ever come to it? (We may well never come to it!)
The reason parents of small kids got the short end of the stick is that the government overreacted to the very small risks to small kids. The solution is to stop overreacting --- not to continue overreacting! Kids will be fine. We should all read some Emily Oster and relax.
Agreed, and I feel for you in this atmosphere of "COVID's over!" I also felt that Walensky's earlier leanings toward school openings didn't acknowledge that my 17- and 18-year-olds are physiologically adults and thus as susceptible to COVID as the college students they were so desperately trying to contain.
Matt's "discussion" of the CDC and public health measures has always been problematic and has veered toward libertarianism (and a few things around it), but he has never acknowledge that. He has made judgments and declarations based on values, but never acknowledged the values. He has suggested recommendations towards goals without being clear about his goals.
This is quite the opposite of how he addresses housing, where his value and goals are clear -- to himself and to his readers. (Whether are are libertarian strains there is more complicated question.)
Matt suggests that the CDC should do little (nothing?) more disseminate the best scientific knowledge at the time, with a narrow definition of "science" and a very restrictive view of an expert's domain. (Lucky for him, he's not the kind of expert that should be so limited.) But that is not the charge of the CDC. Heck, it's clear in the very NAME of the organization that they should be CONTROLLING DISEASE, not just disseminating pre-print scientific studies. He is suggesting -- over and over again -- the that CDC (and basically the public health community) should not concern itself with the impact of their actions on disease spread and public health.
Let me take one piece of this: What is obligation to those around us? More specifically, to what degree must I take on *additional* burden to support others because there are too many selfish and ignorant assholes around us?
That's a moral question and a values question. That is not an objective question with a clear definitive answer.
If people are going to basically lie about their vaccine status because they can't be bothered to wear a mask, does that suggest that mask mandates should stay in place for the vaccinated? Well, that depends to your answer to the question above. Some would say, "Obviously not." Other might say, "Yeah, people suck. But we ARE our bothers' keepers."
There are parts of the country with shockingly low vaccination rates. Alabama and Mississippi (~30%) look to be vaccinated at something like half the rate of Vermont and Maine (~60%). And there is certainly enormous variation across communities within states. There are workplaces with single digit vaccination rates. Here in Connecticut, towns vary from ~30% to over 80%
Where vaccination rates are high, there simply would be far fewer people to lie about status to avoid having to wear a mask, placing a burden to cover for them on many more people. But in other parts fo the country, there are relatively few vaccinated people to bear this unfair burden and many many more who would lie about their status.
But Matt seems to be relying on the idea that because everyone can get vaccinated, they can elect to make themselves safe and protected. So, the folks who have done so shouldn't have to bear a burden to cover for others. But not everyone CAN get vaccinated. And some people who get vaccinated do not have strong immune system responses.
Do we have an obligation to them? How much of an obligation? Do we have any sort of obligation to try to protect those who refuse to get vaccinated from the potential consequences of their decisions? How much of a burden must all of us take on in order to protect the foolish and shortsighted?
These are the hardest questions in public policy -- be it disease control or any other sphere.
Why do we have seatbelt laws? Why do we have helmet laws for motorcycle riders in most states? Other than bloodstains on our pretty asphalt, why don't we just let them be as risky as they choose?
I wrote "seems to" because Matt is not addressing the values issues upon public policy issues are made. What values are you aiming to serve? What goals are aiming towards?
One can criticize much of the what the CDC, Fauci an the public health community has said on the grounds of effectiveness and honesty, while STILL acknowledging values and goals. Why not do that?
Clearly CDC is supposed to do things to control (affect the outcome) of the spread of disease. But the main instrument they have is the dissemination of information, including information of the type If people change their behavior is certain ways the spread of disease will be less than if the do not (a contingent recommendation). My contention is that they did not control disease very well in part because:
a) they did not inform people and policy makers about how individuals' behavior affected others rather than just themselves.
b) they did not keep the information either up to date or sufficiently locally situation specific, which undermined the credibility of all the information.
I don’t see anything about “the CDC shouldn’t lie” that leads towards libertarianism. And no offense (really), but given how ludicrous that statement is, that’s about where I stopped reading. I mean come on.
"Matt suggests that the CDC should do little (nothing?) more disseminate the best scientific knowledge at the time, with a narrow definition of "science" and a very restrictive view of an expert's domain. (Lucky for him, he's not the kind of expert that should be so limited.) But that is not the charge of the CDC."
Regardless of the name, the CDC's job is actually to deliver information and recommendations, not to control behavior. At times, I've been disappointed with CDC this year for the semi-truthful information delivered with spin and manipulation. (I understand why they did it, but it decreased trust in the CDC) . I've written about this before, but it is astounding to me how the left has become so controlling -- mandate/force people. When did the left become so ready to blindly trust the government? Also astounding to me what passes for "libertarian" these days. Yesterday, at our office mtg, we discussed continuing the masking policy in our office (primary care office), which is recommended by public health. We're getting push-back from patients about it. My support of the masking at this point has little to do with Covid. Rates are super low; LA has one of the highest vaccination rates. But when fall comes and people are coming in with respiratory viruses of all sorts, it will help protect people. It makes sense in a doctor's office, but not necessarily for Covid specifically.
"But not everyone CAN get vaccinated. And some people who get vaccinated do not have strong immune system responses.Do we have an obligation to them? How much of an obligation? Do we have any sort of obligation to try to protect those who refuse to get vaccinated from the potential consequences of their decisions? How much of a burden must all of us take on in order to protect the foolish and shortsighted?"
Did you worry about those people in prior years during flu season? You are being emotional, not logical here. People make foolish and shortsighted decisions all the time. At this point, vaccination for Covid is a tiny fraction of those bad decisions. What are the morbidity and mortality statistics related to alcohol (drunk driving, liver disease, spousal abuse...). Should we go back to abolition?
1) Yes, recommendations. The CDC should deliver recommendations.
2) The left has been accused of favoring a "nanny state" for decades. This is nothing new. But none of this about blindly trusting "the government." This is about which experts, serving which values and in the furtherance of which goals.
3) Yes, in fact I DO worry about these people during flu season. I urge people to get flu shots -- particularly those most suspectable to the flu, but others, too. Of course, COVID is more deadly than flu. Long COVID is more common than long flu. Long term health consequences of COVID is far worse than long term health consequences of flu. So, while I DO worry about these people, I know that it is appropriate to worry MORE about them with COVID than with flu.
4) Where am I being emotional? Or is it just that concern for my fellow man counts as emotional, as a rule?
5) Don't get me started on the horrible ways that we culturally view alcohol. It is THE gateway drug. It is responsible for massive numbers of deaths, huge amount of disease. Violence and oppression of spouses and children. It damages relationships. It is horrible. No, we cannot abolish it, but we can tax it. We can make it harder to get. We have have stricter laws and stricter enforcement on alcohol-related harming of others under the influence. No, I doubt that we can do anything about the way that people equate "party" with "alcohol," but we clearly should be doing far more limit the harms of alcohol in our society. Instead, we argue about legalizing pot and the broader war on drugs. Alcohol is widely available, widely abused, and incredibly harmful. In fact, I wrote my state senator about precisely this issue just last week. So, yeah, perhaps you should allow for my being consistent in my liberal controlling condescension and favoring of the nanny state, even if only to protect those are who are vulnerable to the actions and decisions of idiot self-centered assholes.
4) You are being emotional regarding the continued, intense focus on Covid. The vaccines are 95% effective. This is a preventable illness at this point. There are thousands of respiratory pathogens out there. Flu vaccines are 30-50% effective. We shall see, but my guess is that the morbidity and mortality from influenza will be higher in 2022 than from Covid. I disagree with you say that it is appropriate to worry MORE about Covid than about flu at this point. That's why I am calling your arguments emotional, not logical.
How many people did flu kill last week? How many do you think it will kill next week?
How many people do you think will die of flu this fall?
Putting your head in the sand and ignoring that fact that COVID is still killing THOUSANDS of people every week is not rational. My being more concerned about the ongoing deaths of thousands of people every week from COVID is not merely emotional.
Seriously, how many COVID deaths do you think will happen through the rest of this year? How many flu? And that's just deaths.
The number of covid deaths last week is certainly higher than the number of flu deaths last week. But not clearly higher than the number of flu deaths in an average week in a normal March or April.
So, you're suggesting that COVID in it's least deadly weeks of the year is less deadly than flu in its most deadly weeks of the year?
I suppose. And every person I know was once smaller than a Jack Russel Terrier. But so what?
The deadliest COVID weeks are far more deadly than the deadliest flu weeks. The least deadly COVID weeks are far more deadly than the least deadly flu weeks. I every week on the calendar, COVID is more deadly than flu.
Yes, that has been true for the past year (i.e., 52 weeks), in this country. My guess is that that will remain true in the next year, well. I hope not, but our vaccination rates are so low in many parts of the country that its hard to see how that will change.
If people don't care about the deaths of people who elect not to get vaccinated, they should just say so. And, if they want to be consistent, they should urge the end of all those nanny state laws designed to protect people from themselves.
Influenza kills between 35,000-60,000/year. Deaths in the US over the last week is in the hundreds, not thousands, and coming down. And, again, there is a vaccine open to everyone 12 and older that is extremely effective -- much, much more effective than masking. If you want to have a discussion that masks should be required in public places to prevent all sorts of respiratory illnesses in the future, I may disagree, but that is a rational argument. I consider the intense focus on masks for prevention of Covid specifically not a rational argument at this point.
On 6/17/21, COVID killed 291 people in this country. BIG drop from the day before. But things jump around a little bit from day to day.
Regardless, let's just use that 291 number, from a Thursday. 291 times 7....carry the two....2,037. Yesterday, COVID was Killing at weekly rate of over 2,000. That's like 8% better than actual number killed in the last seven days (2,212). Yay, progress!
Let's hope that the increased vaccination count we saw yesterday (was it actually the highest in a month? I saw that somewhere) is a sign of a trend. Let's hope that actual realities of the delta variant are not as bad what I've seen suggest.
And let's all base our evaluations of what is appropriate or needed or advisable or reasonable on the facts.
These are facts. They are not emotions. They are facts.
In the last year, flu deaths drops to almost nothing -- due to the COVID safety procedures we have used. But in the last year, we've had hundreds of thousands of COVID deaths in this country. Apparently, flu deaths are more easily prevented than COVID deaths.
If you extrapolate the current rate of COVID deaths to a whole year, you'd have 124,000. That is, COVID is still -- now in the middle of summer -- killing at a rate twice the annual rate of influenza deaths. You seem to be mistaking the 7-day average with the 7-day total. Yes, daily deaths are like 1/10th of their peak, but that still leaves thousands dying a week. Rather than 30,000 deaths/week, we are down to 2,400. Excellent progress but still appalling.
Walensky was probably right to say that vaccines were good enough that, if you were vaccinated, a mask is really secondary. However, I do wish that she (and this article) had been a bit clearer that there are still people who can't get vaccinated or who are not protected by it. This includes kids under 12, although they seem to be relatively safe regardless. However, it also includes people with various medical conditions, including people on immunosuppressants. This latter group is not only not protected by the vaccine, but are at high risk if they get it. These people can't just go get vaccinated and unvaccinated people wearing masks protected these people.
I'm not sure that this justifies mask mandates forever, but it probably justifies them until case rates get low enough or vaccine rates get high enough that these people are not at that high of a risk.
The thing that always killed me about objecting to masks is that, in most circumstances, it just isn't that big of a deal. This goes double for vaccines, which should just be mandatory without a medical excuse.
My feeling is that masks were no big deal when wearing them was doing me and others good, but now that I’m vaccinated they feel like an increasingly unbearable burden.
"But in practice, the policy distance between “strict rules that we don’t enforce” and “weak rules but most people try to be cautious” is not nearly as great as the political fighting would imply. And a lot of the dialogue on “do Covid mitigation measures work?” has, I think, failed to properly distinguish between the measures and the policies."
^^
This particularly hits home in Japan, where the progressive expat community that is loud on Twitter about how feckless the weak rules are in Japan consistently falls quiet when "State of Emergency" rules that basically just ask restaurants to close at 8pm and stop serving alcohol actually do reduce cases of Covid in Tokyo.
"What is true, though, is that the impact of Covid restrictions has been modest."
We learned what restrictions made sense as we went along. At first there was an assumption that SARS-CoV-2 spread by surfaces/touch, so we had all these restrictions about cleaning surfaces and washing hands. It made sense at the time, but it all turned out to be useless.
Then we believed it was all about droplets (which fall to the ground within six feet) so we distanced by six feet and wore any old mask. The distancing turned out to be useless and most of the masks, and/or the way they were fitted, turned out to be of marginal use.
Then we finally learned that it was really all about aerosols and that the most important thing by far was indoor ventilation. We learned that masks had to be high filtering and tight fitting all around the edges. Most people continued to wear masks that could uselessly stop droplets but barely make a dent in aerosols (often due to big gaps on both sides of the nose).
It was a learning process, and by the time we learned what we needed to know it was too late, and many people were too confused by the ever-changing story to get it right anyway.
Covid restrictions can't work if they are the wrong ones, but we couldn't have known what the right ones were without first having gone through the whole process.
I read the Mandavilli article before reading your rebuttal. I did think Mandavilli's opening gambit of declaring "missteps" smacked of tough-journalism theater, but I did not find the profile negative as a whole.
Mandavilli quotes people we respect as praising Walensky, calling her the best person for the job, and predicting a good press for her by the end of a year (Fauci). Those positive remarks also imply, as Mandavilli recaps at the end of the article, that "the flawed communications in recent weeks suggest that she is still finding her way." I think your point is that the communications were not flawed, but that's less than a major objection to a largely positive profile.
I don't know about Mandavilli's track record, but this piece did not strike me as anything like doomerism. By the way, responsibility for the raised-eyebrow headline and subhead almost certainly lies with an editor, not the author.
Isn’t part of the hopeful outcome of the CDC guidelines to promote vaccination by admitting you don’t need a mask after full vaccination? There was a big surge of vaccine appointments after the announcement. Also since the CDC changed their guidelines, Covid cases continued to fall. Was there any evidence anywhere of an uptick in infections?
I really appreciated this piece.
The other day a man drove past me on a dirt bike, popping a wheelie down a residential street at dusk, helmetless - but wearing a surgical mask, which he carefully adjusted with one hand after landing his front wheel on the road.
It was funny, but reminded me yet again that normal people just plain suck at any sort of risk assessment. If you are reading through multiple articles to try to figure out how to model the relative risk of various behaviors so you can understand the tradeoffs, then you are a weirdo. As am I.
It's frustrating watching the public health establishment implicitly accept that people suck at this to some degree, but then conclude that that's why they need to manipulate everyone - because they just won't "get it" otherwise. The opposite conclusion is more reasonable: people suck at this, so we should try to make all of our communications simple, clear, fact based, and as far as possible, intuitive. ("People breath the virus out, so if you're gonna spend time inside, open a couple windows" is not something you need a complicated risk assessment to understand) The CDC's communication is far from perfect now, but it's vastly improved since the Trump administration ended.
I was on a shuttle heading to a wedding last weekend for a very progressive and liberal friend of mine who has a very liberal and progressive social circle. I noticed everyone had masks on (and were vaccinated) but I was the only one wearing my seatbelt as we drove down the freeway. Later that night they passed around and drank from a bottle of whiskey and somebody said "hey we're all vaccinated". I thought "yeah, from covid, but not from lots of other diseases". Still drank the whiskey of course of I'm not a complete buzzkill
Maybe the guy on the dirt bike was a risk taker with his own safety. but concerned about yours.
One issue with that is you can't say "open some windows" without data confirming that will actually work. And since we can't throw random people in a room with someone sick and see what happens and then try it again with a new group and an open window, you're kind of stuck.
Not a dig at you personally, but this kind of thinking drives me crazy. Are we really institutionally unable to reason under uncertainty?
If I kidnapped 100 epidemiologists and lock them in individual rooms with COVID positive patients and a single window, would any of them not open the window and stand next to it?
Life doesn't wait for perfect info for perfect communications. We have to do the best we can with what we have. In April of 2020, that would have meant telling people to open a window if they insisted on being inside with others outside their households.
And if you're honest about the limitations of your data, and why you're making the best recommendation that you can, people are more likely to listen when you update based on new data. If they sense that you're BS'ing them from the start, they're going to suspect that you're still BS'ing them when you change the guidance.
In the kidnapping scenario, the epidemiologists have no cost to opening the window - if it's efficacy isn't negative, they might as well. It might be hygiene theater but there's no cost to them for doing it.
On one hand, reasoning under uncertainty is necessary. But if we have _no_ real data, I think guessing is counter-productive. So I don't need double-blind trials for the open window theory but some evidence other than "epidemiologists would do it if they had no other options" is needed to reason under uncertainty.
It seems like common sense that opening windows increases ventilation and airflow. By how much exactly I don't know. But there are plenty of studies on air circulation so data for making inferences is out there.
My common sense says that if I have 10 people in my dinning room and I open the window on a calm day, the little bit of breeze would somewhat decrease the concentration of viral particles. But not by much.
Picture you're at a dinner party with 10 people in your dining room and a few of them are smoking. Would opening the windows make a little bit of difference in lowering the smoke in the air or a lot?
I was thinking about a Smokey kitchen as an example. It helps a little. But if they or the stove are still smoking it’s still going to be pretty Smokey. Now if you’re saying put a box fan in one of the windows? That would make a huge difference. Especially with some cross ventilation. But that’s a lot more than just open a window.
Sounds like you’re saying the CDC should Stay In Its Lane.
I have noticed that a lot of people I know are very upset about the CDC rolling back mask requirements and the reason is usually that it freaks them out because it seems unsafe to them. And they’re the type who’ve spent the last year saying the believe in a science. They also spent early 2021 consuming news from sources that insisted we had no idea if the vaccines prevented infections so they also had to get used to the idea that being vaccinated means you almost certainly can’t infect others.
Some of that could have been mitigated if the CDC had done a better job of communicating risk throughout the pandemic.
Or if the CDC had *ever* done a better job of communicating risk. They seem to speak a language entirely of "do"s and "don't"s, with no "A is riskier than B is riskier than C, and you can use this information together with your priorities to determine which things you should and shouldn't do".
Also, I always want to rant about how carcinogens are classified - by strength of *evidence* that an association exists with cancer, and *not* by degree of risk increase:
"The lists describe the level of evidence that something can cause cancer, not how likely it is that something will cause cancer in any person (or how much it might raise your risk). For example, IARC considers there to be strong evidence that both tobacco smoking and eating processed meat can cause cancer, so both are listed as “carcinogenic to humans.” But smoking is much more likely to cause cancer than eating processed meat, even though both are in the same category."
https://www.cancer.org/cancer/cancer-causes/general-info/known-and-probable-human-carcinogens.html
Also everything in the state of California causes cancer but fortunately they label it so that residents can avoid it all.
Does that also explain why everything in the state of California is always on fire?
I want to very strongly push back on the idea that health authorities were lying about masks. IIRC the best studies they had at the time were out of Vietnam during SARS and the question was, "Does wearing a mask in the home with someone who is sick with SARS prevent infection?" And they answer is not really. But that's an entirely different question than does wearing a mask in line at the supermarket or while getting your hair cut prevent transmission. The answer to that is most certainly yes.
For more detail:
https://slatestarcodex.com/2020/03/23/face-masks-much-more-than-you-wanted-to-know/
He's my spirit animal.
This is a good post, but with some weird lacunae.
Did Abbott "jump the gun" by removing mandates on March 2? Matt is pretty fair in judging the motivations behind his actions, but shouldn't we inquire what happened next? When the March 2 order came out, Texas cases had dropped 65% from its mid-January high. And after the mandates were removed? Well . . . cases dropped another *85%* (https://www.worldometers.info/coronavirus/usa/texas/) Maybe he just got lucky, but I'd rather my governor be lucky than smart.
The other thing that irks me is the debate about masks early on: >>What the experts didn’t know is that apparently, it’s pretty easy to make a cloth mask. <<
Not sure what this means but it doesn't make any sense. Does it mean, folks, it's easy to make a mask at home? Well, maybe, and people would have done that, but only after emptying all the stores of masks, insuring healthcare personnel couldn't get them. Humans, you know. Or did it mean that factories could easily make cloth masks? Maybe, but that sure wouldn't have happened immediately. I have a good friend who managed the supply chain for a group of California hospitals and the stories he tells of trying to get supplies -- including masks -- early in the pandemic are chilling. People rushing out to CVS would only have made that much worse.
So, sure, the CDC shouldn't lie (credibility and all that), but how would telling people that masks were good have possibly helped protect vitally needed supplies for healthcare workers? It was a rock and a hard place and there was no obvious right answer. I can't blame them too much.
Couple of niggling things bother me. Your faith in Hepa filters for one. HVAC systems are an excellent way of distributing disease as Legionnaire's Disease demonstrates so well. And I assure you that if you are placed between the air return or inlet of any filter system and a person shedding virus into the air it does not matter how efficient the filter system is. You are in the line of fire. But there are, as you remark, other kinds of expertise.
Now let me channel Donald Rumsfeld. There is a lot you could and should criticize about that man but his known knowns speech is not one of them. And we have a bit of a problem here of the known unknown variety. That would be the fact that evolution never sleeps. The rise of new variants was easily predictable by virologists and anybody else who knew the elements of this theory but not much covered in the press until they began to appear. Frankly that scared me more than anything else and still does. Evolution is still not sleeping and there is no reason whatsoever that new variants that are more transmissible, more lethal and which affect different demographic groups like children cannot arise. Every single case of infection represents an opportunity for evolution. Any long term strategy to contain Covid must take this into account. Nowhere in this piece is that very serious problem considered.
As a supplemental let me ask, what do you suppose will happen if a new strain arises that our current vaccines do not work well against.
We’ll get new vaccines.
Everyone knows that. The interesting question is what the United States will do during those couple months when the new variant is spreading among vaccinated people, while everyone is lining up to get their new vaccine. Will we go back to full-time isolation and work from home and masking?
And even faster as we will just be tweaking the existing vaccine.
It is impossible for us to go any faster in creating the vaccine. Why? Because it took us *two days* for moderna to make the vaccine. The rest is bureaucracy.
We shall die by suicide, or not at all.
You call making sure it doesn’t kill people (Phase 1) and actually works (Phase 2) is just bureaucracy?
I'm so sick of the people who think it's the government's job to play jedi mind tricks to manipulate the population into doing things. It's the government's job to provide information and reasonable guidance informed by that information.
So instead of saying, "Masks only work for doctors; regular schmucks like you can't possible use them correctly," they should have said, "Masks are useful, but doctors and first responders need them more than you do, so please don't horde them." Instead of saying "COVID is a serious risk for your average 20-year-old, so get vaccinated to save yourself", say "The risk of COVID to your average 20-year-old isn't very big, but please take one for the team and get vaccinated to help people at higher risk than you."
The people who advocate for these jedi mind tricks tend to also be the people who wonder why the people who don't fall for these jedi mind tricks have such low faith in government. Just treat people like adults. If you want to change people's mind, hire Frank Luntz to manipulate people like adults https://debeaumont.org/news/2021/focus-group-vaccines-republicans/ (Not a sentence I expected to type.)
This is exactly right. This idea that you can turn around people who are skeptical of government officials by shading the truth is nuts. You just provide ammunition for the people who want to undermine the message. Sticking to the facts is a much better strategy.
My observation has been that academic schools of public health are extremely paternalistic, and tend to attract students who are both earnest and highly controlling.
Yes, this is a good point. I am a graduate student in public health and the default position here for any given issue is that the government should dictate what people can do.
It’s worth noting that “The people who advocate for these jedi mind tricks tend to also be the people who wonder why the people who don't fall for these jedi mind tricks have such low faith in government” is natural when you think about it - they’re just projecting their own credulity downward.
Agreed. It's both expected and super frustrating. I wish more people had a more developed theory of the mind https://slatestarcodex.com/2015/11/03/what-developmental-milestones-are-you-missing/
"But Texas’ motor vehicle fatality rate is 37% higher than California’s and Florida’s is 63% higher. I have no idea what accounts for those gaps. But whatever it is, we manage to not be having entrenched culture war fights about it."
Traffic fatalities are a function of miles driven and impact intensity. Impact intensity is called "Delta-V" or the change in velocity during impact. The industry benchmark is fatalities per 100 millions miles driven.
California is at 1.06.
Texas is at 1.21 (14% higher than California).
Florida is at 1.41 (33% higher than California).
So part of your per-capita difference is higher miles driven and the other part is traffic. So speeds in Texas and Florida are higher than California which increases accident intensity.
Emily posted this link from 2019. I have 2020 but I don't know if it's published yet.
https://www.iihs.org/topics/fatality-statistics/detail/state-by-state
"Traffic fatalities are a function of miles driven and impact intensity. "
Also distance to emergency medical care. Deaths per 100 million in MA is 0.51. In Montana it's 1.43. It's not because MA has better drivers, it's because they have quicker access to better hospitals.
That's interesting. One factor I haven't studied. There's also a trucks vs. vehicle rate factor and age / $ of vehicle which impacts safety ratings.
https://en.wikipedia.org/wiki/Golden_hour_(medicine)
Thank you for bringing some common sense to this (too often senseless) debate over masks.
In our household we noted that the CDC Director's kids are old enough to be vaccinated, where-as in our household, our 4-year old and 2-year old are not. It's not the case that if you want the vaccine you can get it--you also have to be over 12 years old. And, while for now, we don't anticipate major risks to little kids, that could certainly change with the new variants. I've generally felt like parents of small kids have gotten a short end of the stick this last year and the CDC's approach didn't acknowledge our position any better.
If the existent variants of the virus aren't a serious risk to small kids, then why should the government take preemptive action to mitigate risks from hypothetical, nonexistent variants of the virus? Why don't we cross that bridge if we ever come to it? (We may well never come to it!)
The reason parents of small kids got the short end of the stick is that the government overreacted to the very small risks to small kids. The solution is to stop overreacting --- not to continue overreacting! Kids will be fine. We should all read some Emily Oster and relax.
Agreed, and I feel for you in this atmosphere of "COVID's over!" I also felt that Walensky's earlier leanings toward school openings didn't acknowledge that my 17- and 18-year-olds are physiologically adults and thus as susceptible to COVID as the college students they were so desperately trying to contain.
Matt's "discussion" of the CDC and public health measures has always been problematic and has veered toward libertarianism (and a few things around it), but he has never acknowledge that. He has made judgments and declarations based on values, but never acknowledged the values. He has suggested recommendations towards goals without being clear about his goals.
This is quite the opposite of how he addresses housing, where his value and goals are clear -- to himself and to his readers. (Whether are are libertarian strains there is more complicated question.)
Matt suggests that the CDC should do little (nothing?) more disseminate the best scientific knowledge at the time, with a narrow definition of "science" and a very restrictive view of an expert's domain. (Lucky for him, he's not the kind of expert that should be so limited.) But that is not the charge of the CDC. Heck, it's clear in the very NAME of the organization that they should be CONTROLLING DISEASE, not just disseminating pre-print scientific studies. He is suggesting -- over and over again -- the that CDC (and basically the public health community) should not concern itself with the impact of their actions on disease spread and public health.
Let me take one piece of this: What is obligation to those around us? More specifically, to what degree must I take on *additional* burden to support others because there are too many selfish and ignorant assholes around us?
That's a moral question and a values question. That is not an objective question with a clear definitive answer.
If people are going to basically lie about their vaccine status because they can't be bothered to wear a mask, does that suggest that mask mandates should stay in place for the vaccinated? Well, that depends to your answer to the question above. Some would say, "Obviously not." Other might say, "Yeah, people suck. But we ARE our bothers' keepers."
There are parts of the country with shockingly low vaccination rates. Alabama and Mississippi (~30%) look to be vaccinated at something like half the rate of Vermont and Maine (~60%). And there is certainly enormous variation across communities within states. There are workplaces with single digit vaccination rates. Here in Connecticut, towns vary from ~30% to over 80%
Where vaccination rates are high, there simply would be far fewer people to lie about status to avoid having to wear a mask, placing a burden to cover for them on many more people. But in other parts fo the country, there are relatively few vaccinated people to bear this unfair burden and many many more who would lie about their status.
But Matt seems to be relying on the idea that because everyone can get vaccinated, they can elect to make themselves safe and protected. So, the folks who have done so shouldn't have to bear a burden to cover for others. But not everyone CAN get vaccinated. And some people who get vaccinated do not have strong immune system responses.
Do we have an obligation to them? How much of an obligation? Do we have any sort of obligation to try to protect those who refuse to get vaccinated from the potential consequences of their decisions? How much of a burden must all of us take on in order to protect the foolish and shortsighted?
These are the hardest questions in public policy -- be it disease control or any other sphere.
Why do we have seatbelt laws? Why do we have helmet laws for motorcycle riders in most states? Other than bloodstains on our pretty asphalt, why don't we just let them be as risky as they choose?
I wrote "seems to" because Matt is not addressing the values issues upon public policy issues are made. What values are you aiming to serve? What goals are aiming towards?
One can criticize much of the what the CDC, Fauci an the public health community has said on the grounds of effectiveness and honesty, while STILL acknowledging values and goals. Why not do that?
Clearly CDC is supposed to do things to control (affect the outcome) of the spread of disease. But the main instrument they have is the dissemination of information, including information of the type If people change their behavior is certain ways the spread of disease will be less than if the do not (a contingent recommendation). My contention is that they did not control disease very well in part because:
a) they did not inform people and policy makers about how individuals' behavior affected others rather than just themselves.
b) they did not keep the information either up to date or sufficiently locally situation specific, which undermined the credibility of all the information.
I don’t see anything about “the CDC shouldn’t lie” that leads towards libertarianism. And no offense (really), but given how ludicrous that statement is, that’s about where I stopped reading. I mean come on.
"Matt suggests that the CDC should do little (nothing?) more disseminate the best scientific knowledge at the time, with a narrow definition of "science" and a very restrictive view of an expert's domain. (Lucky for him, he's not the kind of expert that should be so limited.) But that is not the charge of the CDC."
Regardless of the name, the CDC's job is actually to deliver information and recommendations, not to control behavior. At times, I've been disappointed with CDC this year for the semi-truthful information delivered with spin and manipulation. (I understand why they did it, but it decreased trust in the CDC) . I've written about this before, but it is astounding to me how the left has become so controlling -- mandate/force people. When did the left become so ready to blindly trust the government? Also astounding to me what passes for "libertarian" these days. Yesterday, at our office mtg, we discussed continuing the masking policy in our office (primary care office), which is recommended by public health. We're getting push-back from patients about it. My support of the masking at this point has little to do with Covid. Rates are super low; LA has one of the highest vaccination rates. But when fall comes and people are coming in with respiratory viruses of all sorts, it will help protect people. It makes sense in a doctor's office, but not necessarily for Covid specifically.
"But not everyone CAN get vaccinated. And some people who get vaccinated do not have strong immune system responses.Do we have an obligation to them? How much of an obligation? Do we have any sort of obligation to try to protect those who refuse to get vaccinated from the potential consequences of their decisions? How much of a burden must all of us take on in order to protect the foolish and shortsighted?"
Did you worry about those people in prior years during flu season? You are being emotional, not logical here. People make foolish and shortsighted decisions all the time. At this point, vaccination for Covid is a tiny fraction of those bad decisions. What are the morbidity and mortality statistics related to alcohol (drunk driving, liver disease, spousal abuse...). Should we go back to abolition?
1) Yes, recommendations. The CDC should deliver recommendations.
2) The left has been accused of favoring a "nanny state" for decades. This is nothing new. But none of this about blindly trusting "the government." This is about which experts, serving which values and in the furtherance of which goals.
3) Yes, in fact I DO worry about these people during flu season. I urge people to get flu shots -- particularly those most suspectable to the flu, but others, too. Of course, COVID is more deadly than flu. Long COVID is more common than long flu. Long term health consequences of COVID is far worse than long term health consequences of flu. So, while I DO worry about these people, I know that it is appropriate to worry MORE about them with COVID than with flu.
4) Where am I being emotional? Or is it just that concern for my fellow man counts as emotional, as a rule?
5) Don't get me started on the horrible ways that we culturally view alcohol. It is THE gateway drug. It is responsible for massive numbers of deaths, huge amount of disease. Violence and oppression of spouses and children. It damages relationships. It is horrible. No, we cannot abolish it, but we can tax it. We can make it harder to get. We have have stricter laws and stricter enforcement on alcohol-related harming of others under the influence. No, I doubt that we can do anything about the way that people equate "party" with "alcohol," but we clearly should be doing far more limit the harms of alcohol in our society. Instead, we argue about legalizing pot and the broader war on drugs. Alcohol is widely available, widely abused, and incredibly harmful. In fact, I wrote my state senator about precisely this issue just last week. So, yeah, perhaps you should allow for my being consistent in my liberal controlling condescension and favoring of the nanny state, even if only to protect those are who are vulnerable to the actions and decisions of idiot self-centered assholes.
Quick reply. (I got to get to work).
4) You are being emotional regarding the continued, intense focus on Covid. The vaccines are 95% effective. This is a preventable illness at this point. There are thousands of respiratory pathogens out there. Flu vaccines are 30-50% effective. We shall see, but my guess is that the morbidity and mortality from influenza will be higher in 2022 than from Covid. I disagree with you say that it is appropriate to worry MORE about Covid than about flu at this point. That's why I am calling your arguments emotional, not logical.
How many people did flu kill last week? How many do you think it will kill next week?
How many people do you think will die of flu this fall?
Putting your head in the sand and ignoring that fact that COVID is still killing THOUSANDS of people every week is not rational. My being more concerned about the ongoing deaths of thousands of people every week from COVID is not merely emotional.
Seriously, how many COVID deaths do you think will happen through the rest of this year? How many flu? And that's just deaths.
The number of covid deaths last week is certainly higher than the number of flu deaths last week. But not clearly higher than the number of flu deaths in an average week in a normal March or April.
So, you're suggesting that COVID in it's least deadly weeks of the year is less deadly than flu in its most deadly weeks of the year?
I suppose. And every person I know was once smaller than a Jack Russel Terrier. But so what?
The deadliest COVID weeks are far more deadly than the deadliest flu weeks. The least deadly COVID weeks are far more deadly than the least deadly flu weeks. I every week on the calendar, COVID is more deadly than flu.
Yes, that has been true for the past year (i.e., 52 weeks), in this country. My guess is that that will remain true in the next year, well. I hope not, but our vaccination rates are so low in many parts of the country that its hard to see how that will change.
If people don't care about the deaths of people who elect not to get vaccinated, they should just say so. And, if they want to be consistent, they should urge the end of all those nanny state laws designed to protect people from themselves.
Influenza kills between 35,000-60,000/year. Deaths in the US over the last week is in the hundreds, not thousands, and coming down. And, again, there is a vaccine open to everyone 12 and older that is extremely effective -- much, much more effective than masking. If you want to have a discussion that masks should be required in public places to prevent all sorts of respiratory illnesses in the future, I may disagree, but that is a rational argument. I consider the intense focus on masks for prevention of Covid specifically not a rational argument at this point.
A little update for you, Elana.
On 6/17/21, COVID killed 291 people in this country. BIG drop from the day before. But things jump around a little bit from day to day.
Regardless, let's just use that 291 number, from a Thursday. 291 times 7....carry the two....2,037. Yesterday, COVID was Killing at weekly rate of over 2,000. That's like 8% better than actual number killed in the last seven days (2,212). Yay, progress!
Let's hope that the increased vaccination count we saw yesterday (was it actually the highest in a month? I saw that somewhere) is a sign of a trend. Let's hope that actual realities of the delta variant are not as bad what I've seen suggest.
And let's all base our evaluations of what is appropriate or needed or advisable or reasonable on the facts.
you want another source? NBC News.
https://www.nbcnews.com/health/health-news/coronavirus-deaths-united-states-each-day-2020-n1177936
That's 2148.
Washington Post: https://www.washingtonpost.com/graphics/2020/national/coronavirus-us-cases-deaths/
335/day (rolling 7-day average). That's 2,345.
Reuters, from as far back as...saturday. 2,891.
https://www.marketwatch.com/story/new-covid-19-cases-and-deaths-jump-to-two-weeks-highs-11623504743
Healthline: 2,432
https://www.healthline.com/health-news/here-are-the-states-where-covid-19-is-increasing-2
What more do you need?
Facts. Thousands. Days are the not same unit of time as weeks.
Deaths in the US yesterday: 434
Deaths in the US the day before yesterday: 346
Deaths in the US in the previous 7 days: 2409
(My source for these numbers all pandemic long: https://www.worldometers.info/coronavirus/#main_table)
These are facts. They are not emotions. They are facts.
In the last year, flu deaths drops to almost nothing -- due to the COVID safety procedures we have used. But in the last year, we've had hundreds of thousands of COVID deaths in this country. Apparently, flu deaths are more easily prevented than COVID deaths.
If you extrapolate the current rate of COVID deaths to a whole year, you'd have 124,000. That is, COVID is still -- now in the middle of summer -- killing at a rate twice the annual rate of influenza deaths. You seem to be mistaking the 7-day average with the 7-day total. Yes, daily deaths are like 1/10th of their peak, but that still leaves thousands dying a week. Rather than 30,000 deaths/week, we are down to 2,400. Excellent progress but still appalling.
Walensky was probably right to say that vaccines were good enough that, if you were vaccinated, a mask is really secondary. However, I do wish that she (and this article) had been a bit clearer that there are still people who can't get vaccinated or who are not protected by it. This includes kids under 12, although they seem to be relatively safe regardless. However, it also includes people with various medical conditions, including people on immunosuppressants. This latter group is not only not protected by the vaccine, but are at high risk if they get it. These people can't just go get vaccinated and unvaccinated people wearing masks protected these people.
I'm not sure that this justifies mask mandates forever, but it probably justifies them until case rates get low enough or vaccine rates get high enough that these people are not at that high of a risk.
The thing that always killed me about objecting to masks is that, in most circumstances, it just isn't that big of a deal. This goes double for vaccines, which should just be mandatory without a medical excuse.
My feeling is that masks were no big deal when wearing them was doing me and others good, but now that I’m vaccinated they feel like an increasingly unbearable burden.
"I'm not sure that this justifies mask mandates forever..."
It doesn't.